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Clinical Medicine > Geriatrics > Flashcards

Geriatrics Flashcards

1
Q

reasons why elderly pop going up

A

baby boomers
up like expectancy
up immigration
down fertility rate

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2
Q

avg life expect

A

84

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3
Q

marriage/living situation

A

42% women widowed

72% of men live with spouse (50% women)

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4
Q

chronic conditions (%s)

A

80% have 1

50% have 2

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5
Q

chronic conditions (health care costs)

A

75% of costs

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6
Q

MC conditions > 65

A

HTN

arthritis

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7
Q

MC deficit

A

walking

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8
Q

what ups likelihood of living in LT care

A

3+ ADL limitations

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9
Q

MCC death

A

heart dz
cancer
stroke

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10
Q

CPG means…

A

clinical practice guidelines

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11
Q

age – fat changes

A

up fat up distribution of lipophilic drugs (anti-psych, TCAs)
up rx 1/2 life

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12
Q

age – muscle changes

A

less muscle mass – rx that bind to muscle need to be lower (digoxin)

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13
Q

age – protein

A

protein binding doesnt change w/ age

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14
Q

age – HR

A

resting HR doesnt change
max HR goes down
208 - age(0.7)

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15
Q

age - vessels

A

up tunica media thickness
down elastin
(up stiff/BP)
predispose to athero

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16
Q

age – BP

A

up SBP more than DBP

up ortho HTN (dizzy not normal tho!)

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17
Q

CV changes: stay same

A

HR

SV

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18
Q

CV changes: up

A

tunica media thickness

vasc afterload

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19
Q

CV changes: down

A

CO
contractility
beta rec responsiveness
elastin

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20
Q

pseudodementia features

A

affects recall
inconsistent deficits
elicits “i don’t know” more often than incorrect answers
less language/global impairments

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21
Q

SIGECAPS

A

depression +

sleep, interests, guilt, energy, concentration, appetite, psychomotor retardation, suicide

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22
Q

first line for depression

A

SSRI or SNRI

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23
Q

first line for anxiety

A

SSRI

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24
Q

MC anxiety

A

GAD

25
Q

gold standard tx for depression

A

ECT

26
Q

prevalence of depression in long term care

A

15% (1% in gen pop)

27
Q

1st sign of atrophy in AD (location)

A

entorhinal cortex

28
Q

tx of choice for vascular dementia

A

lower BP

29
Q

FTD subtype

A

picks

30
Q

lang fxn in HIV assoc dementia

A

usually intact

31
Q

visual disturbances in dementia

A

LBD > AD

32
Q

35-70 dementia

A

FTD

33
Q

better @ recalling words w/ hints?

A

vascular > AD

34
Q

NPH triad

A

wacky wobbly wet

35
Q

family Hx dementia

A

AD, FTD, lewy is sporadic

36
Q

executive fxn deficits

A

parkinsons, AD late, LBD late, FTD early

37
Q

dementia >. 65

A

LBD, AD (not FTD)

38
Q

AD atrophy

A

diffuse

39
Q

LBD features

A

fluctuations in cognitive fxn
persistent hallucinations
spontaneous parkinsons motor features

40
Q

dementia w/ less Ach than AD

A

lewy body

41
Q

LBD atrophy

A

diffuse

42
Q

amyloid plaques w/o NFTs

A

LBD

43
Q

hyperorality dementia

A

FTD

44
Q

delirium features/Sx

A 
acute onset *
fluctuating levels of consciousness*
picking at clothing*
inattention (do digit span test)
memory loss
disorientation
apathy
agitation
delusions 
disturbed sleep
45
Q

dementia features/Sx

A 
memory impairment*
day/night reversal*
hoarding*
disorientation 
agitation
disturbed sleep
46
Q

depression features/Sx

A 
sadness*
loss of interest*
I don't know answers are common*
disturbed sleep
trouble concentrating
down energy
worthlessness
suicide things
47
Q

GDS #s

A

> 5 may be depressed (+ask about suicidality)

> 10 for sure

48
Q

adipose changes with age

A

more adipose

49
Q

glut-4 changes w/ age

A

less glut-4

50
Q

statin w/ lowest risk of myopathy

A

pravastatin

51
Q

meds that raise BP

A 
steroids
sympathomimetics
decongestants
NSAIDs
cyclosporine
tacrolimus
EPO
52
Q

DM blood sugar levels

A

fasting >126, random >200

53
Q

DM goals

A

HbA1C

54
Q

% of elderly with DM

A

20%

55
Q

how to dx ortho hTN

A

take lying down
stand, take after 1/3/5 min
> 20 fall in systolic
>10 fall in diastolic

56
Q

HbA1C >11% needs intervention by when

A

3 mo

57
Q

atypical depression sx

A

j

58
Q

P for irreversible tissue damage

A

> 70 for 2 hrs

59
Q

dementia with progressive gait d/o

A

vascular

hydrocephalus

Clinical Medicine (9 decks)

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